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Home Issue 33 Quarantine facility 'ticking timebomb'

Quarantine facility ‘ticking timebomb’

By ERWIN CHLANDA

A man who was in compulsory quarantine in the Top End’s Howard Springs COVID-19 facility says he observed first-hand breaches of numerous requirements by the Federal Department of Health.

Braedon Earley spent five days in the facility, a 14-day stint cut short because the hotspot in Queensland, where he had been, was declared risk-free.

Mr Earley felt strongly about the shortcomings he is alleging, and embarked on a hunger strike to underscore his points.

He says: “The quarantine facility at Howard Springs is a ticking time bomb.

“It has the potential to be another Stamford Hotel in Melbourne if there was anyone, or a number of people, with the virus in the facility.”

During his stay he says he had contact with 50 or 60 staff and residents, frequently in contravention of the regulations, as he has found out since, but wasn’t told about that during his time in the facility.

Below are published Federal Government Department of Health requirements, each followed by Mr Earley’s comments.

DEPARTMENT: General principles of infection prevention and control in RCFs (Residential Care Facilities): Information about routine IPC (Infection Prevention and Control) should be provided to staff, residents (as far as possible) and visitors (as appropriate). 

EARLEY: I received no induction. Some documents were provided and were subject to change depending on who you spoke to. Not all residents were informed of the changes. 

DEPARTMENT: All staff should be trained in basic IPC practices, when they begin employment at the facility, and at regular intervals. Training should be appropriate to their roles and should include, at least, hand hygiene and the use of Personal Protective Equipment (PPE). 

EARLEY: Not all were wearing full PPE, including police, welfare personnel and rubbish collectors.

DEPARTMENT: Training should be appropriate to their roles and should include, at least, hand hygiene and the use of personal protective equipment (PPE). Hand hygiene using soap and water or alcohol-based hand sanitiser (e.g. after going to the toilet, coughing, blowing the nose and before eating). 

EARLEY: No alcohol based sanitisers were available inside or outside the room for the residents, nor outside or inside the laundry, for the residents.

DEPARTMENT: Appropriate use of PPE, especially when caring for a resident with a respiratory infection. 

EARLEY: No residents knew who was infected or who was not. All residents were mixed together from different flights and different periods of quarantine and were not issued gloves, face shields or eye protection. I had to ask four times to receive another face mask. I was scolded for not wearing my face mask in a humiliating manner by one of the nursing staff, saying: “Everyone knows how to wear a face mask”. There was no facility to dispose of the used face masks or any other clinical waste as bio hazard material.

DEPARTMENT: Cough etiquette and respiratory hygiene for staff, residents (if possible) and visitors. 

EARLEY (at left): Not advised.

DEPARTMENT: Frequent cleaning and disinfection (at least daily) of floors and surfaces. More frequent cleaning of frequently touched or soiled surfaces.

EARLEY: Did not happen.

DEPARTMENT: Annual influenza vaccination of residents, staff and all visitors to RCFs.

EARLEY: I was not given an influenza vaccination.

DEPARTMENT: Standard contact and droplet precautions when caring for a resident with a respiratory infection.

EARLEY: Not observed. There was a guy with hayfever, wanted more medication. They did not help him.

DEPARTMENT: Limiting unnecessary movement of residents and staff within and between facilities. 

EARLEY: People were moving, nearly touch hands and bodies when simultanuously exiting their rooms with the doors close together. Some walked up to 16km a day within facility. People were playing with footballs and others played hopscotch and cards. Exercise was encouraged for up to 20 minutes a day some were exercising in excess of three hours a day.

DEPARTMENT: The virus that causes COVID-19 most commonly spreads through: Direct contact with droplets from an infected person’s cough or sneeze. This can be avoided by cough etiquette and physical distancing.

EARLEY: This was not discussed.

DEPARTMENT: Avoid close contact with an infectious person. 

EARLEY: I did not know who was infected. 

DEPARTMENT: Touching objects or surfaces (e.g. bed rails, doorknobs or tables) that have been contaminated with respiratory droplets from an infected person and then touching the face, especially mouth, nose or eyes.

EARLEY: We would not know who was infected. All surfaces, hard and soft, were touched by staff, with gloves on and residents with no gloves in and around the facility, e.g. handrails, door knobs, washing machines, wheelie bins, tables and chairs, footpaths, food and groceries.

DEPARTMENT: Remind staff and residents of the need for cough etiquette and respiratory hygiene. 

EARLEY: Residents were not reminded.

DEPARTMENT: Staff and visitors in contact with ill residents should follow contact and droplet precautions. Supplies of PPE should be readily available and placed strategically outside the room.

EARLEY: Neither of this happened.

DEPARTMENT: Patients should be monitored for symptoms of COVID-19 at least daily.

EARLEY: I was given only one COVID test. Media from the NT Government say that all those doing quarantine will undergo two tests during quarantine. I had one and was not given the results. We were not tested as we left the facility, in darkness.

DEPARTMENT: They may leave their room for exercise or activity, with supervision by a staff member, if necessary, to ensure that they avoid contact with other residents.

EARLEY: This did not happen.

DEPARTMENT: Standard Precautions are IPC practices used routinely in healthcare. They should be used in RCFs with a suspected or proven COVID-19 outbreak and apply to all staff and all residents: Hand hygiene before and after each episode of resident contact and after contact with potentially contaminated surfaces or objects (even when hands appear clean).

EARLEY: This did not happen for residents, there were no hand sanitisers outside or inside rooms. All hard surfaces were touched by bare hands of the residents.

DEPARTMENT: Gloves are not a substitute for hand hygiene. Staff should perform hand hygiene before putting gloves on and after taking them off.

EARLEY: This did not happen for residents, hand sanitisers were not issued unless demanded.

DEPARTMENT: Use of PPE if exposure to body fluids or heavily contaminated surfaces is anticipated (gown, surgical mask, protective eyewear, and gloves).

EARLEY: This did not happen for residents unless demanded.

DEPARTMENT: Regular cleaning of the environment and equipment. Provision of alcohol-based hand sanitiser at the entrance to the facility and other strategic locations.

EARLEY: This did not happen for residents unless demanded.

DEPARTMENT: RCFs should restrict admission of new residents into the facility. Depending upon the extent of the outbreak and the layout of the building, restrictions may be applied to a floor, a wing or the entire facility. 

EARLEY: New residents were admitted to the facility while other residents were serving a quarantine period and were housed either side by side or adjacent to existing residents. 

DEPARTMENT: Frequently touched surfaces should be cleaned and disinfected frequently. Any resident care equipment should be cleaned and disinfected between each use or used exclusively for individual residents.

EARLEY: Did not happen.

DEPARTMENT: Soiled linen should always be treated as potentially infectious. 

EARLEY: Collection happens every eight days, used linen was handled by people not in full PPE.

DEPARTMENT: Disposable crockery and cutlery are not required.

EARLEY: It was used, bare hands touched it which turned it into biohazard waste. Yet it was put into general waste bin.

DEPARTMENT: Trays and trolleys used for delivery of food should be cleaned thoroughly with disinfectant wipes after use.

EARLEY: Laundry trolleys were used to deliver lunches. 

DEPARTMENT: Clinical waste should be disposed of in clinical waste streams.

EARLEY: There were no clinical waste receptacles or bio hazard bins.

DEPARTMENT: Non-clinical waste is disposed of into general waste streams.

EARLEY: All waste goes to general waste including used face masks, tissues and clothing. I saw them in general waste.

DEPARTMENT: Perform routine cleaning of frequently touched surfaces with detergent / disinfectant solution / wipe at least daily or when visibly dirty.

EARLEY: Did not happen. Areas and items frequently were dirty, from dust and wind, people were touching washing machines, handrails, door knobs and bins.

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